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The AIH Transcript for May 27, 2021

Hosts: Carol Off and Chris Howden

Prologue

CAROL OFF: Hello. I'm Carol Off.

CHRIS HOWDEN: Good evening, I'm Chris Howden. This is “As It Happens”.

[Music: Theme]

CH: Tonight:

CO: Neighbourhood watch. British Columbia is preparing for a “Hug Day”, and Alberta is talking about lifting restrictions -- but federal health minister Patty Hadju says the kind of summer you'll have will depend on what COVID is doing near you.

CH: A sense of long awaited release. The prime minister apologizes to Italian-Canadians detained during the Second World War -- and the granddaughter of one detainee says while overdue, she was still overwhelmed.

CO: After the facts. China says a U.S. investigation into the origins of the coronavirus is a political effort to blame the pandemic on a leak from a Wukan lab -- but a microbiologist says stranger things have happened.

CH: Game misconduct. After Edmonton is eliminated from the NHL playoffs, Oilers defenceman and Indigenous role model Ethan Bear responds to the racist flak he's taken on social media.

CO: He made timeless books look like child's play. With words like “The Very Hungry Caterpillar”, the lead author-illustrator Eric Carle gave children an appetite for reading. A fellow author talks about their friendship, and their mutual love of food.

CH: And... choose your weapon. People with Misophonia are extremely grossed out by the noise of people eating. So scientists are trying to help by putting their research money where your mouth is.

CO: “As It Happens”, the Thursday edition. Radio that typically avoids talking smacks.

[Music: Theme]

Part 1: Minister Hajdu, Eric Carle Obit

Minister Hajdu

Guest: Patty Hajdu

CH: Patty Hajdu has more than one pandemic on her hands. Canada's Minister of Health has to plot a course through a world where, in some countries, COVID patients are dying for lack of oxygen -- while in others, people are offered free beer to roll up their sleeves for a vaccine. And in Canada, Minister Hajdu is coordinating help for Manitoba where COVID-swamped hospitals have been forced to send patients for care in other provinces' ICUs. That's in the same week that governments in BC and Alberta are talking about lifting pandemic restrictions, very soon. We reached Minister of Health Patty Hajdu in Thunder Bay, Ontario.

CO: Minister Hadju, in British Columbia, we're hearing Bonnie Henry talking about "Hug Day" in July, and Alberta, Jason Kenney wants to see everything back to normal in Alberta by July 1st, by the end of June. So what's your date for when Canada should open?

PATTY HAJDU: Hmmm, well, thanks for the question. I don't really have a hard and fast date, but what I would say is that it's really important that the premiers and the decision-makers listen to the science tables on a slow and cautious reopening. What we don't want to see as a resurgence of the virus in a way that can't be controlled. And we're seeing provinces struggle as we speak. I mean, as you know, Manitoba has just received health care workers to support with their significant surge. Ontario has received support. Alberta has received support. And certainly, what we want is to be able to ensure that we have enough people vaccinated, that when we do have an outbreak of COVID that we can quickly put those flames out.

CO: We heard from Manitoba doctors on this show who blame the province for not shutting down early, for giving mixed messages. And that's the same we've heard from other provinces that struggled, as you just mentioned. So why do you think Canada's provinces have not been able to learn from one another's mistakes?

PH: Well, I would say two things. I think, one, there is an immense pressure for everyone, I think, decision-makers to open up. And we see this debate, you know, as soon as case numbers start to decline, of course, various sectors are eager to resume business activity. They're eager to get back to their lives. People are... are tired of public health measures. But the challenge is that, of course, when we reopen too quickly, we actually delay the economic restarting of these regions and of Canada. And we've now learnt that lesson three times, I would say. [slight chuckle] And I'm hoping that the provinces and territories and local decision-makers are realizing that the best and safest and most economic, prosperous path forward is actually ensuring that we have all the measures in place to take care of outbreaks of COVID-19 that are small. And we act quickly when we see those outbreaks so that we don't get ourselves in this situation that we've most recently come out of.

CO: But Canadians are looking over the border, looking into the United States, where we're seeing the country opening up. We're seeing the concerts, ballgames, people everywhere without masks, having a good time. And some parts of the United States where the vaccination rates are still very low. So if Canadians are saying, what gives? I mean, why are they open? Is there another way? Is there another way to do this? Maybe we should just take the risk and go for herd immunity? What do you say to people who look at the States and say, what about us?

PH: Well, it's difficult to answer that question with any kind of specific... with... with specifics. Because, of course, different parts of the United States are experiencing different things. But I will say this. I think herd immunity has proven to be extremely dangerous and very, very difficult to reach without the assistance of vaccination, without the assistance of ensuring that you have a robust testing and tracing strategy, ensuring that you have the ability from a health human resources perspective to manage those outbreaks as they occur. And I just think that we've learned, hopefully, our lesson here in Canada that pursuing any type of herd immunity without the additional protection of vaccination is not realistic and too many lives are lost. And furthermore, we see that it's not good for the economy either. I think there's this false dichotomy that exists that somehow if we just learn to live with the virus and let it rip, that it will be better for the economy. And time and again, that's been proven false. When the virus is spreading in an uncontrolled fashion, then what we see is that people are reluctant to... to go out. They're reluctant to pursue their day-to-day activities. And, of course, we have to impose very harsh measures as those numbers continue to climb. So I think the path that we're on, careful, cautious with a strong focus on getting as many Canadians immunized as possible, is the right path to actually have sustained success with this virus.

CO: We are… have been almost begging the United States to share its extra doses of vaccine with us. At the same time, you are just now calling on the provinces to start sharing the unused doses of AstraZeneca before they expire. In some cases, in a matter of days, these doses will expire. We may see tens of thousands of doses expired before going into people's arms. I mean, won't our name be mud [soft chuckling] around the world if we let that happen?

PH: Well, certainly, I've worked with my provincial and territorial colleagues over the last several months to make sure that they have plans to use all doses that we've delivered to them as efficiently as possible. And we've regularly talked about this at the health ministers table. And, yes, I've just sent a letter to remind them that we have significant federal resources to move those doses around to provinces and territories that can use them. I know that provinces are considering the use of AstraZeneca for second doses. Ontario has begun that. And we stand ready to assist because I share the perspective of Canadians that we should not be wasting both doses. And AstraZeneca doses, as you know, many Canadians stepped up to take AstraZeneca. About 2.3 million of us have received our first immunization of AstraZeneca. And so those doses are useful for second doses. And so, we'll continue to work with the provinces to move those doses around so that they get used efficiently.

CO: Can you see... I mean, people are reluctant because of all the mixed messaging they've had about the AstraZeneca vaccine. We had the same day that the prime minister was telling Canadians that you should just take the first one you can, and he's willing to have... he wants the second dose to be AstraZeneca. But, at the same time, we heard the chair of the National Advisory Committee saying that she wouldn't recommend it to her own family. And you were saying that, well, you should just take the advice of your doctors to what you should take. I mean, [chuckling] it feels like this mixed messaging contributed to people being reluctant to go and take the AstraZeneca?

PH: Well, Carol, I don't think it's helpful when... when people misquote what NACI said. I understand that the communication was confusing. But, in fact, what we were talking about -- and what NACI was talking about -- was, A, that physicians and immunizers know best about your own personal risk factors and, in fact, screen for those significantly and are the best people to advise you about what appropriate immunization plans for you and, you know, and you're in your own family. And secondly, that AstraZeneca does pose a very rare risk of blood clotting in very specific circumstances, and that as COVID decreases in all of our communities, of course, the risk of side effect increases as a result of the fact that there's less COVID in communities. But I'll say this. The people have stepped up to take AstraZeneca -- and 2.3 million Canadians, by the way, did -- including me, and the prime minister, as you point out, did so because we wanted to be, first of all, protect ourselves and we wanted to be part of the work of our community to protect against the spread of COVID. And I want to thank all Canadians who have done that. And I want to also say to those Canadians that second doses will be available and that Canada will have options available, whether it's, you know, a mixed dosing strategy that the province or territory pursues or whether it is a second dose of AstraZeneca. We will ensure that the science guides those decisions, and provinces and territories will have the science, and they'll have the vaccines available to administer the second doses.

CO: But, I mean, if you're still trying to clarify what NACI said, it's had a great effect. I mean, you can't deny that that and other remarks about the threats of this blood clot had an effect on policy -- that the provinces stopped administering it. And now,m you're trying to get... encourage them to get it into people's arms before it expires. I mean, it does feel a bit improvised, doesn't it?

PH: Well, actually, it doesn't feel improvised. What it feels like is that the scientists responsible for guiding provinces and territories and for guiding Canadians is actually working. And that the scientists are… are doing an incredible amount of work. And, you know, their due diligence on ensuring that they understand, you know, what the emerging science is and giving the appropriate advice to provinces and territories that are then taking that advice and applying it to their own particular provincial or territorial situation. And, you know, again, what we're seeing is the opposite of what you're suggesting, which is hesitancy. What we're seeing is Canadians saying, I want to get immunized. When is it my turn? How do I step up to protect myself and my family and my community, and stop the spread of COVID-19? And for that, I'm incredibly encouraged. And I think we are underestimating the sophistication of Canadians. Canadians understand that this is a new virus. They understand that guidance may change. And they also know that the institutions that are there to protect their health are doing their job.

CO: Why are the vaccines going to expire and refrigerators in the couple of days then?

PH: Well, as I said, you know, and I think you're asking a question that you know the answer to, Carol. [laughing] The first doses have been paused in many provinces and territories. And provinces and territories are deliberating about what to do about second doses? We know that the risk of a blood clot for second doses is much, much smaller and... than... than with first doses. And so provinces and territories are... are awaiting further guidance from NACI on the potential of dose mixing, on whether or not to proceed with AstraZeneca for second doses. And... and many provinces have begun. Ontario has begun, as you know, to offer second doses of AstraZeneca to some of the first people to accept AstraZeneca in March, and that's good news. And what I'm saying to provinces and territories is my letter is let's make sure that we move that product around so that we can make the best use of it as it... as it is valuable, and it will help ensure full protection of many people who receive those doses earlier on in March.

PH: Can you appreciate, though, how confusing that might be? You said that... that people can get the advice of their doctor. A lot of people don't even have a doctor. A lot of people don't have access to a doctor. So if all these these mixed messages about, well, maybe AstraZeneca, you shouldn't have maybe you maybe you should have it. Maybe you should wait and get Pfizer for your second one. We... we haven't got all the studies in yet. How are people to... to sort through all this that they don't have the kind of advice that some people have, and many others don't?

PH: Well, I think that question, you know, is somehow implying that pharmacists and public health authorities that are also helping with immunization are not obviously doing a screening. Of course, they are pharmacists, public health officials. All the immunizers are fully-equipped to ask the questions, to determine people's health records, to be able to understand if the vaccination that is being offered to that individual is appropriate for that individual circumstance. And I have to thank all of those immunizers. I mean, we see general practitioners, as I said, pharmacies who have, by the way, immunized people forever, public health officials who are often at the forefront of immunization campaigns. These are also very skilled health care providers that ask questions that do that screening prior to someone being immunized and can help an individual determine whether or not that particular vaccine or immunization strategy is right for them.

CO: Just one last quick question. I know you do have to go, but we've just seen the Biden administration say that it's going to now investigate whether or not the origins of COVID-19 came from a lab in Wuhan? What's Canada's position on that?

PH: I think we've been clear from the beginning that we anticipate and we expect a full investigation of the origins of COVID-19. Obviously, we want, just like the rest of the international community, to understand how this virus arose and what we can do to prevent future global pandemics? So we've been clear with the WHO, with... with our counterparts at the G7 that we are extremely interested in understanding the origins of COVID-19 as well.

CO: Minister Hajdu, I appreciate your time on As It Happens". Thank you.

PH: Thank you very much, Carol. Bye-bye.

CO: Bye-bye.

CH: Patty Hajdu is Canada's Minister of Health. We reached her in Thunder Bay, in northwestern Ontario. You can find more on that story on our webpage at: www.cbc.ca/aih.

[music: jazz]

Eric Carle Obit

Guest: Tony DiTerlizzi

CH: "Heaven just got more colourful." That's what the author Peter H. Reynolds wrote on Twitter, following the news of Eric Carle's death. And even if you didn't know Mr. Carle by name, you knew his work. Especially "The Very Hungry Caterpillar". That children's book, filled with colourful pages, saw a ravenous caterpillar eating its way through apples, plums, strawberries, chocolate cake, and salami -- and also, eating a hole in the book. It became a bestseller after it was published in 1969. But it was only one of more than 70 books that Mr. Carle worked on over his lifetime. He died this weekend at the age of 91 in Massachusetts. On the 40th anniversary of "The Very Hungry Caterpillar," the British book store Waterstones shared an interview with Eric Carle.

SOUNDCLIP

ERIC CARLE: I love colour, and I have this one frustration that I cannot be even more colourful. That the range of what our eye see is... is so, so limited. The caterpillar is going to be 40 years old, and I'm going to be 80 years old. I think aside from the story, aside from the graphics, you know, that touchable holes and the learning that's camouflaged in there. I think it's a book of hope. You can grow up, fly into the world with your talents. I remember when I was little, you know, I thought I'll never grow up and do what grown-ups do. I'll never make it, and so forth. Growing up can be very difficult. It's a big secret. It's a big challenge for children. I like to help the children along. Of course, I'm gratified that it has had such an impact. I think it's translated in 45, 46 languages.

CH: Tony DiTerlizzi is the co-creator of the children's book series "The Spiderwick Chronicles", and was a friend of Eric Carle. We reached him in Amherst, Massachusetts.

CO: Tony, first of all, I'm sorry for your loss.

TONY DITERLIZZI: Oh, thank you. Thank you so much.

CO: When you hear that clip of Eric Carle talking about his work, talking about "The Very Hungry" Caterpillar, talking about kids and their need for hope, what comes back for you?

TD: The colour actually is the first thing I think of. You know, Eric came over here, you know, post-war Germany. He came to America with a suitcase. That's it, with his belongings. And then, you know, to become a world-renowned, celebrated, award-winning children's book artist and author, and to erect the first museum in America dedicated to the artistry of picture books. You know, he looked to the colour in the world. He looked to the vibrancy, the beauty, not just in the colours, but in all of the natural beauty that surrounded him, that... that I feel like we're vertically closer to when we're children [chuckling]. He understood that so intrinsically, you know, it's not just caterpillars, but the crickets and the ladybugs, and the fireflies, and all the things that he focussed on for his stories.

CO: The colours are just... I don't know how he gets them so vivid? They glow. But he... there is an interview with him -- with... with Eric Carle -- who says that one of the reasons why he loved colour so much is that, as you just mentioned, he came from Germany after the Second World War, and he had, as a teenager, been forced to dig trenches by the Nazis, and... and everything was just so colourless where he was. Did he ever talk about that?

TD: He would from time to time. My dad was in Vietnam, so its… I always grew up where you don't really ask so much about it. But if someone's willing to express or talk about it, you know, you listen. And so, occasionally, he would talk about it. He certainly talked about, you know, his love of art school in Germany when he was there studying and the encouragement that he received from his instructors and professors. I think he carried that encouragement through and certainly shared it with the librarians and teachers who... who are educating our children and share his books in their classroom. I know that the educators meant a tremendous amount to him and to the books that he created.

CO: Do you remember yourself the first time you read "The Very Hungry Caterpillar", and what you thought of it?

TD: [bright chuckle] I don't. It's one of those things like "Where the Wild Things Are", where it's just part of my childhood landscape. Like, it was always there. It was always present. It was, you know what I mean? Like, it was just always something that was in your room or in a library. But I do recall when my wife and I brought our daughter home from, you know, the hospital when she was born. And it was the first book we sat down and read. You know, we put a little copy, a little board book copy of it, in her lap, and we read it to her and, you know, off she went.

CO: What do you think the message is in that book?

TD: We all have the ability to change. And we all have the ability to evolve into something more beautiful. And also, food is amazing! [both laughing] And that's true with Eric. Eric loved... loved to eat. We... we... we certainly had many a hangout over food. Here in Amherst, in Northampton, there's quite a few children's book folks here that came in from the 60s, like Eric and Norton Juster and Jane Yolen. And then there's kind of been a new generation who have moved up here due in huge part to... to the museum that Eric opened. And so, I've been fortunate enough to spend time. We had a guys lunch that Mo Willems had kind of organized where it would be Eric and Norton Juster and Moe and I. Norton being the the author of "The Phantom Tollbooth", we lost a few months ago. And we would sit around, and we would... we would certainly talk shop a little bit, but we would just mostly, you know, eat and tell old stories. And it was joyous and amazing. And with both of those legends gone, there's certainly an absence now.

CO: What an extraordinary lunch that must have been.

TD: [hearty laughter] It was a lot of laughter and a lot of like, hey, try this! This is pretty good! We'd get sushi or… [chuckle], so Norton... Norton loved... loved food as well. He was a big foodie. And so he would... I remember we were... there was an event at the museum. And my wife and I were driving Eric home afterwards. And Norton said, you know, we should get together soon. And Eric said that would be a very good idea. And Norton goes, I'll bring the schnecken in. And he goes, oooo, schnecken! [CO chuckles] I love schnecken. And so we're driving him home. It's 10, 15 minutes from the museum. And... and he's telling us, you know, what schnecken is, and he's like, you've never had schnecken?! And I'm like, I've never had schnecken. So we go to his... he had a place in Northampton. He goes, would you drive a little bit past there? And there was a bakery, and he, you know, toddles in and comes back out with a bag, and he goes, all right, come on up. We're going to have schnecken. And it's basically snails -- German for snail, I believe. And so it's like a cinnamon roll that's kind of twisted around like a shape of a snail shell. And we all sat and ate schnecken, and then that kind of became the running joke every time we'd get together for… [CO chuckles] Oh, look, you brought more schnecken! OK, it was… [laughing]

CO: What will you miss the most about your friend?

TD: [deep sigh] You know, Eric... the life of a children's... I think many authors, not just children's book authors or illustrators, it's a solitary one. We're alone in our studios or offices, writing and working. And Eric was a model for a lot of... for myself, and for…. for many young up-and-coming children's book creators of how to be generous, how to be classy. You know, he was always very generous with gifts, with his time. He was a true inspiration. And... and he didn't have to be. He'd earned… [laughing] he'd earned his legendary status. And yet, he always took time to talk to children, to draw on their books, to spend time with... with families and librarians and teachers and young kid artists like me who, you know, had big dreams of one day making my own books for children. And that kind of inspiration is something I will always carry with me and try to pay forward and pass along.

CO: What a loss!

TD: Indeed.

CO: Tony, thank you for telling us about Eric Carle.

TD: It's my pleasure.

CO: Bye-bye.

TD: Bye.

CH: That was Tony DiTerlizzi in Amherst, Massachusetts, speaking about his friend, Eric Carle -- who created "The Very Hungry Caterpillar." Mr. Carle has died at the age of 91.

[music: smooth jazz]

Mouth Sounds

[sound: birdsong]

CH: The soothing sound of birds. They may be yelling out the crassest possible pick-up lines -- but all we hear are pleasing songs.

[Sound: Oh, this sounds like a crowded restaurant! Remember those?!! Those were great!!!

CH: The murmur of a crowd of people. Not unlike birdsong, in a way. And in that reassuring burble, the knowledge that humans are social creatures, eager to communicate.

[sound: loud chewing and lip-smacking]

CH: The, uh, okay. The perfectly natural sound of someone eating an apple -- reminding us that, ugh, sorry, that we must all sustain ourselves by...reducing food to a mush in our wet mouths, in order -- OK, would you… would you please turn that off. Uh, thank you! That was the worst! I guess I have a touch of what's called "misophonia" -- a strong dislike of certain sounds. Most commonly, the sounds of chewing and slurping. And now, new research may have found a reason. People with misophonia have a stronger connection between the part of the brain that processes sound, and the part of the brain that's in charge of the motor function of the mouth and throat. Dr. Sukhbinder Kumar of Newcastle University told The Guardian, "What we are suggesting is that, in misophonia, the trigger sound activates the motor area even though the person is only listening to the sound. It makes them feel like the sounds are intruding into them." He suggests that, if you're freaking out at someone's chewing noises, you could pretend to chew. Thus giving yourself back a sense of control. So between this new information, and this helpful exercise, we've given you...a lot to chew on.

[music: Indie pop]

Part 2: Italian-Canadian Internment Apology, China Lab Leak Theory

Italian Canadian Internment Apology

Guest: Joyce Pillarella

CH: Italian-Canadians have been waiting for an apology for more than seven decades. And today, Prime Minister Justin Trudeau finally delivered it.

SOUNDCLIP

JUSTIN TRUDEAU: When on June 10th, 1948, this House of Commons declared war on Mussolini's fascist regime in Italy, Canada did not also have to declare war on Italian-Canadians. To stand up to the Italian regime that had sided with Nazi Germany. That was right. But to scapegoat law-abiding Italian citizens. That was wrong. Mr. Speaker, Signor Presidente, I rise in this House today to issue an official apology on behalf of the government of Canada for the internment of Italian-Canadians during the Second World War. To the men and women who were taken to prisoner of war camps or jail without charge, people who are no longer with us to hear this apology. To the tens of thousands of innocent Italian-Canadians who were labelled enemy aliens. To the children and grandchildren who have carried a past generation's shame and hurt, and to their community, a community that has given so much to our country, we are sorry. [apologizing in Italian].

CH: The Prime Minister making a formal apology in the House of Commons today, to the families of an estimated 600 Italian-Canadians who were interned during the Second World War. Joyce Pillarella was instrumental in eliciting that apology, after she learned that her grandfather was interned in the 1940s. We reached Ms. Pillarella in Montreal.

CO: Joyce, what was it like for you to hear that apology from Prime Minister Trudeau today?

JOYCE PILLARELLA: I was crying because it was, for me, it'd been over 20 years that I'd been working on this project. And I've talked to about 150 families across Canada. So all their stories sort of become my stories in a way. And so, to hear the apology today was very powerful because so many people had felt abandoned for so long. They were able to tell their stories, and they were listened to.

CO: And you gathered so many of those stories to make this case for this apology. And so... but you also learned about your own grandfather and his internment during the Second World War -- one of the people that Mr. Trudeau was speaking of. What did you learn about what happened to him?

JP: Well, I mean, what happened to him happened to so many others in the fact that in 1939, they had these regulations that were created by the minister of justice that allowed them to intern people, even Canadian citizens who were born in countries at war with Canada. And that's what happened to my grandfather. And that's what happened to so many Italians. They didn't need to have any evidence, or they didn't have to prove anything that these people had committed any sort of crime. They were able to just arrest them, send them to camps, and they didn't need any proof of anything. So then I learnt what happened to my grandfather, but at the same time, it happened to everybody else.

CO: Where was your grandfather taken?

JP: He was arrested here in Montreal, and then he was sent to Petawawa in Ontario. What they did with the men is they kept them in either the jail or… like, in Toronto, they kept him at the CNE centre. And that was really, really hard for all the men because in stories, when they were there, like, for example, in Toronto, people would come by, they were spitting at them, they were being intimidated, they were... they were being frightened by the guards, making them feel like they were going to be shot. Here in Montreal, they went to Bordeaux jail. So you can imagine people that were like doctors and professionals and just law-abiding Italian-Canadians, quite frightening for them.

CO: How long was your grandfather kept there?

JP: He was kept for three and a half years. So he went from Petawawa, and then he was transferred to Frederickton camp.

CO: What does your mother say about the effect that had on your family?

JP: Well, she... she didn't talk about it that much. What she would talk about was the... the gags and the pranks that my grandfather would do at the camp with the mayor of Montreal. And so this is what frustrated me, because I said, well, there's got to be more than just like the guy is not going to go to an internment camp for three and a half years just to play pranks. And then I started researching at the archives. And it was only when I started working with families and interviewing families that I got the complete story. So it was... I wanted more than just the top-down. I also wanted the bottom-up on the stories.

CO: I understand your mother got involved as well with this. What did she do?

JR: [thundurus laughter] My mother got me the interview. Because, at the beginning, people didn't want to talk, and they were afraid of being misjudged. They said, oh, you know, they felt insignificant. They didn't want to go back to the pain. So when I was making cold calls, I was trying to be really soft and nice. But, basically, I was getting hung up on, or they just didn't want to talk to me. And my mother, who was 90 years old and living with us at the time, decides that, you know, I'm going to make the phone calls. She felt sorry for me. And so she got on the phone, and she started... she took a different approach. She was basically giving out orders and telling them, listen, we have to set the record straight. We have to tell people that our fathers were innocent. We have to tell Canadians about what happened in Canada in 1940. You have to talk to my daughter. And then she handed me the phone, and I'd have, like, you know, an older person on the other end of the line going, your mother said, I have to talk to you. [both chuckling] And that's how it started. And so, you know, she started doing this. She was basically, you know, sending out her commands, and they listened to her because it wasn't just her age, but because it was personal. With that, you're able to get to stories that people have suppressed for 80 years or have not even told their children about or were just afraid, were shamed. And so the stories came out. The stories came out one after the other.

CO: And, as I'm sure you know, there are those who question this apology, historians who say that this was... there was a very small group of men who went to, unlike the Japanese, who went to internment camps. And that there were many Italian fascist party sympathizers in Canada. They were card-carrying members of the party, and that some of those interned may have been those who supported the Italian fascist party, which meant that they would also be committed to Mussolini and his fascist government. What do you say to those who criticize this apology?

JP: Well, I think the fact that they criticize the apology is all the more reason why this apology needs to be done. Because they even admit that there's an absence of evidence, and it's this undeserved stigma that somehow all these people are guilty of something. And this is exactly what has dogged the families for 80 years. And so... and this is why they were afraid to speak. And so, the apology seeks to remedy that injustice. And it basically declares once, and for all, no, these people were wrongfully interned. And as far as whatever they thought of, you cannot arrest a person for a thought. You're not respecting basic rights of people. And that's not a Canadian thing to do.

CO: What happened to your grandfather after he was interned?

JP: Well, he lost his job, and then he eventually got another job at another steel... steel plant. A lot of the older internees also when they came out of the camp, most of them were described by their children as a broken man. And so the younger ones were able to, you know, get back and do stuff. But many of them had a hard time because they had an Italian name. They were afraid. So you had people that were executives in large companies working as a cashier in a restaurant or night watchman and even then, losing their job as soon as somebody found out that they were in Italian.

CO: What do you think your grandfather would think of this apology?

JP: I think they've already all opened up a bottle of wine, and they're having a toast. And they're... they're very pleased. And they're all dressed in their Sunday best. And they're looking at us with a smile and saying thank you.

CO: OK, well, Joyce, that's a nice image. And I appreciate speaking with you. Thank you.

JP: Thank you so much, Carol. Thank you.

CO: Bye.

JP: Bye.

CH: Joyce Pillarella's grandfather was interned during the Second World War. We reached Ms. Pillarella in Montreal.

[music: folk]

Ethan Bear Edmonton Racism

CH: The Edmonton Oilers are officially out of the running for the Stanley Cup -- after being eliminated by the Winnipeg Jets in the first round of the playoffs on Monday. And Oilers fans have been overwhelmingly, and unfairly, blaming one person for the loss. Defenceman Ethan Bear is 23. He hails from the Ochapowace First Nation in southern Saskatchewan. On Monday night, the Oilers coach benched him in the third period, after a turnover led to the Winnipeg Jets tying the game. The Jets went on to win in triple overtime, and winning the series. Ethan Bear never left the bench. So began the angry online comments -- many of them anonymous, and many of them abusive and racist -- all directed at Ethan Bear. And yesterday, the Indigenous NHL-er responded by video.

SOUNDCLIP

ETHAN BEAR: As you know, I've been subject to racist behaviour on social media. And I know this doesn't represent all Oilers fans or hockey fans. And I greatly appreciate your support and your love during this time. I'm here to stand up to this behaviour, to these comments. I'm proud of where I come from. I'm proud to be from Ochapowace First Nation. And I'm not just doing this for myself. I'm doing this for all people of colour. I'm doing this for the next generation, to help make change, to love one another, to support one another, to be kind to each other. There's no place for racism in our communities, in sports or in our workplace. So I call on all of us to help make change and to end racism. We all deserve to be treated fairly. And at the end of the day, I think we'll get there.

CH: That was Oilers defenceman Ethan Bear. His uncle, Evan Taypotat, spoke to the CBC today about the impact the social media messages have had on the family.

SOUNDCLIP

EVAN TAYPOTAT: Well, I think first and foremost, I just chatted with Ethan’s mother, Geraldine, who's a cousin of mine. And they're in Edmonton supporting Ethan. And they drove up as soon as all the bad stuff happened the other night. I think it was two nights ago. And, you know, everyone's in agreement in that's the line of work he’s in, in that professional athletes, you're allowed to criticize them. They get paid pretty good cash, you know, to play in the best hockey league in the world. And... and that's fine. If someone makes a bad pass and we get scored on, that's just part of it. But what you're not allowed to do, you’re not allowed to criticize people's heritage of race and colour of skin and ethnicity-based on a bad pass which resulted in a goal. You have to support them on the good days, and you have to support them on the bad days. So for us, I think, the calling of names on his Instagram account, through his direct messages, was completely uncalled for. From a First Nations standpoint, obviously, I’m a First Nations chief and a fan of the Oilers, and I've always been a fan even before my nephew played for them. We actually want to thank the haters for saying what they did and doing what they did because they've given Ethan this awesome platform right now to show the world that First Nations people, Indigenous people, we actually aren't bad people, but we're not going to stand down. We aren't going to let online nameless trolls who hide behind anonymous names. We will not let them win. Ethan will not let them win. This has just stoked the fire in him that, you know, he's ready for next season already. He wants to train. He wants to come in bigger, better, faster. And he wants to show the world that, you know, despite his skin colour, he’s just as good as anyone. And he's going to handle it professionally. And he's not going to... he will not let the haters win.

CH: That was Evan Taypotat, uncle of Edmonton Oilers defenceman Ethan Bear, speaking to CBC Saskatchewan today.

[music: vocalization]

China Lab Leak Theory

Guest: David Relman

CH: In Beijing today, Chinese officials accused Joe Biden of politicizing the pandemic. They're angry about the U.S. President's announcement yesterday that he wants American intelligence to redouble efforts to root out the origins of COVID-19. That includes the disputed theory -- much trumpeted by the previous U.S. president -- that the pandemic was caused by a virus escaping a virology lab in Wuhan. A WHO report has dismissed the idea. But earlier this month, a group of prominent scientists signed a letter that was published in the journal Science. It called for a full investigation into the virus's origins, including the possibility that it got out of a lab. Stanford microbiologist and MD, Dr. David Relman, is one of the organizers of that letter. We reached Dr. Relman in Palo Alto, California.

CO: Professor Relman, why did you decide to sign this letter appealing for an investigation into the origins of COVID-19?

DAVID RELMAN:: We were concerned about several things. We were concerned that not all reasonable hypotheses were being treated in an objective, rigorous manner. We were also worried that as time lapsed, we were not further along in understanding where the... how the pandemic began?

CO: But how is that possible after... I mean, this is more than a year. How do we still not know what his origins are?

DR: It's important to say, first of all, that finding the origins of an outbreak can be a really difficult thing to do. And in this particular case, it's complicated ecology, ecology that involves lots of potential animal reservoirs living in habitats that are poorly understood, as well as the people that are intruding on and modifying those environments. And that includes the way in which we move animals about and force encounters with viruses. But it also includes the work that humans do in working on viruses, collecting them, trying to understand them by manipulating them. And that whole ecosystem is complex.

CO: OK, the two possibilities that you mentioned there, one, which I guess is zoonotic spill-over, which is a virus that's been transferred from animals to humans. In this case, the theory is it came from a bat in a market. But then there is what's called the lab leak theory. And so is that what you're wondering as to why we're not having a proper investigation into that possibility?

DR: That's correct. We have pretty good evidence that this virus, at some point in the past, was probably living in a bat. And so the question is, how did this virus get presumably from a bat into a human? And there are two kinds of scenarios. One are scenarios in which the virus went from bat directly to human or bat through another animal to human. And the other involves a laboratory where the virus spent some time in a laboratory before then having contact with a human. And you're right, we... we don't have any direct evidence for either. The evidence for each of these hypotheses is entirely circumstantial. But what struck us as a little unfair and not proper from a scientific point of view was the way in which one of these hypotheses or scenarios was being appropriately addressed with all rigour and seriousness. But the other was being just almost summarily dismissed as if it was craziness.

CO: Can you tell us a bit about what some are thinking could be a possible source of a lab leak?

DR: Right, the closest known relatives of the virus are found in bats, but they're found in bats about 1,000 miles from Wuhan, which is the place where disease first arose, as best we know. Meanwhile, in downtown Wuhan is what is probably one of the largest collections of bat coronaviruses anywhere in the world. And then you factor in, again, it's circumstantial, but the fact that laboratories suffer from accidents far more often than we would like to think or even know. But the idea would be that perhaps in the midst of well-intentioned work by well-intentioned scientists seeking to understand what else is out there in nature, they collected a sample which, unbeknownst to them, contained sars-cov-2. And in the process of trying to recover the virus from the sample, they may have grown it to just a limited enough degree to not even know that the growth experiment, you know, was a success. And so they threw the sample out. But in the process, they became infected because, again, they wouldn't have known how transmissible and infectious this virus is. And then, because many people are asymptomatic, this well-meaning scientist went home infected, only to spread the infection elsewhere in the city. So that's one scenario. Another scenario is that, again, through well-intentioned, well-meaning work, some manipulations of that coronaviruses were undertaken, and some very close ancestors to the current virus, ancestors that we don't yet know about, these ancestors were being manipulated in the laboratory to understand them. And as a result, sars-cov-2 was born. And again, this would require that we... we hear a little bit more about some of the experiments that were going on in these laboratories, which to this point have remained essentially unavailable to us.

CO: Why do you think China has made it unavailable even when there was a chance to have that investigated and be potentially discounted when the WHO scientists went over to investigate?

DR: Yeah, I really don't know. And I can only tell you, in general, most scientists I know are very interested in having the truth be told. But they're also worried about sometimes a story that is incomplete. Sometimes those that oversee the science are worried about how it might be viewed by others. And in this case, the work was being done in a country that cares very much about its image. So I can only imagine that it's a sensitive issue for anybody who is close to this origin question.

CO: For many people, the lab leak theory has been discounted because of the people who... who first championed the idea, who are people who are known to say things that are not true, like President Donald Trump and others. And so it was... was discounted as an idea, like up there with injecting bleach. And so, do you think that that's part of the reason why it hasn't been looked at is that the people who were insisting that it was the case were not to be trusted?

DR: Absolutely. Just in talking to my colleagues by simply even just asking the question, how certain are we? Are you sure? You're simply feeding this counternarrative. And I'm very concerned about this. I'm concerned about the degree to which this whole discussion and the tone and tenor of world controversy has led to this difficulty in having just a fair and dispassionate discussion about the facts. It's certainly not good for international relations, but it's also not good for science. I just think that at this point, we have to really be fair, clear, neutral as best we can and simply, you know, call a spade a spade. What do we really know? Show us the data. Let's, you know, have a fair discussion about what the various interpretations of the data might mean, but we can't even begin if we don't see the data.

CO: Professor Relman, you've given us a lot to think about here, and I appreciate that. Thank you.

DR: You're most welcome.

CH: Dr. David Relman is a medical doctor and Microbiology Professor at Stanford University. We reached him in Palo Alto, California.

[music: groove]

Part 3: Feature Jen Gunter

Feature: Jen Gunter

Guest: Jen Gunter

CH: There are many times in women's lives that are biologically complicated. And if academic literature, popular culture, and everyday conversation are any indication, puberty and pregnancy are chief among them. They are the moments when -- according to the still overwhelmingly patriarchal logic of most contemporary societies -- a girl becomes a woman ... and a woman proves her worth. Books and blogs about both abound. Many of which actively dismantle those minimizing stereotypes. And Jen Gunter fully supports that. Information is, after all, a good and empowering thing. But the kind of information we do share makes the kind of information we don't share very telling. And these days, she's telling anyone who will listen that when it comes to menopause, far too much goes unsaid. Dr. Jen Gunter is a gynecologist and pain medicine physician. Her new book, The Menopause Manifesto is out this week. She joined Carol for a feature conversation from her home in Sunnyvale, California.

CO: Jen Gunter, first of all, welcome to “As It Happens”.

JEN GUNTER: Thank you so much for having me.

CO: And people should know, since we're talking to Jen Gunter, that we are going to... you're going to hear vaginas and vulvas discussed here. [laughing] So anyone who is squeamish about that, you are forewarned, right?

JG: Absolutely.

CO: You call this book The Menopause Manifesto. Why a manifesto?

JG: I think that I wanted to stake a claim about the truth of menopause, that for too long we have been sold the story of weakness, of frailty, of lack of worth, of ovarian failure. And that's just not true. And so I wanted people to really think of me standing on my soapbox, you know, yelling the truth about menopause.

CO: You begin with... well, in part about the actual history of the word menopause. And you say a number of places that words matter. I mean, the terms that are used to describe a woman's body, the processes the body go through are very significant. And this word, menopause is something that you looked at quite closely. What is the history of that word?

JG: Yeah. So menopause is, you know, derived from two Greek words. It simply means the end of menstruation, really. But, you know, the way we think about words affects what we think about that object or that experience. And I really began to think a lot about the words that we use in medicine and how so many of them, especially directed towards women's health, are negative. So, you know, if you were told that the changes that are happening to your vagina are atrophy, vaginal atrophy, which is the old term that used to be used. So, first of all, yeah. Who wants to tell their partner that their vagina is... they've got vaginal atrophy. [CO chuckles] I mean, it just sounds so awful, you know? And women are told to be quiet, and they're... they're sort of assigned a societal irrelevance with age. And so anything that sort of reinforces that idea of shrinkage or getting smaller is really doubly harmful here.

CO: So when you go back to those... those... those people who first… men, of course, male doctors who wrote about it, some of them use... were understanding, some of them got it in a way that was rare at the time. We're talking about 18th century, 19th century discussions of what this... this... this condition is, [chuckling] this process, this change. Where did you find any place where... where it seems to be that people understood what women were going through?

JG: Well, I think obviously looking at, you know, these physicians from the 1500, 1700s, 1800s, you know, their understanding, you have to look at their understanding with the knowledge of the day because, you know, in the 1600s, they didn't know hormones existed, right? So they didn't really understand ovulation. They didn't understand the science. But putting it in perspective, yeah, there were some people who, you know, believed that, you know, menopause wasn't a death and that it was just another phase of life. And it's interesting to me that those physicians, you know, their narrative didn't become the dominant one because that wasn't the belief of the day. I mean, the belief of the day was that women were physically inferior to men, that our cells were weaker, that we were overly moist, like we retained fluid in a way that men didn't. And if everything that you think about a woman's body is negative or pejorative, then, you know, medicine is going to reflect that. And so if you're someone who's not in that stream of thinking and is trying to change the view, it's easy to see how society, your medicine sort of brushes those people over. But that's no excuse. But you can just kind of see how it happens.

CO: There’s one phrase that you used to sort... this kind of sums this up. Is that… that men, this is how it's regarded, men, age and women are betrayed by their wombs, can you expand on that?

JG: Yeah, I mean, we see that even reflected today. I mean, look at all the... the male action stars in their 50s who, you know, they're with their… you know, they’re partnered in the movies with someone who's in their early 20s. If you're 35, you're too old to be their spouse. Yeah, I mean, it's... it's again, this distilling a woman's worth to her reproductive function. And this idea that as you age when, you know, the ancient physicians used to believe that it was doubly worse because menstruation was toxic. So if you weren't menstruating anymore, all those toxins were building up inside your body. So, you know, if you're a menopausal woman and you have a shoulder pain, well, it's your uterus. And if you're a man who's 555 who has shoulder pain, well, obviously you work too hard and injured your shoulder.

CO: [chuckling] and you point out how absurd an equivalent concept such as erectilepause would be if it was applied to men's health.

JG: Yeah, I mean, think about it. We don't describe men in terms of their reproductive function. You know, we don't say that, you know, a 60 year old man has entered his erectilepause if he has erectile dysfunction. So why are we... why are we defining women by their menstruation, right? I mean, menopause is literally the end of menstruation. We're able to define people in their, you know, their young adult years without saying that they're in menarche. You know, menarche is the medical term for the start of periods, right? [CO chuckles] So imagine if we said to 22 year old women, oh, you're menarchal, how's that going for you?

CO: But at the same time, OK, from a strictly biological point of view, right? That we are, as animals, we are… we had this... we are compelled, obliged, physically designed to reproduce, right? That's what we do. And so that's an imperative. Men don't run out of sperm. And it diminishes, but they don't run out of sperm. We run out of eggs. So doesn't that biological difference contribute to some of this thinking?

JG: Oh, I'm sure it does. Although, again, you know, the patriarchy is writing the narrative. And so while it's technically true that 75-year-old men, most 75-year-old men have sperm, their ability to actually impregnate someone is much lower than, you know, the patriarchy would have You think. They're not all you know, verial, running around impregnating, you know, people on a daily basis. So I just think it's important to say, yeah, obviously there are these biological differences. But, you know, we've also evolved, you know, we're not at the whim of our biology or I'd like to think that.

CO: But within that... the biology, just keeping with that for a moment. There.. as you write in the book, there are no other female animals that stick around for so long after they are unable to conceive. So why do human animals do that? Why do women do that?

JG: Well, we do and toothed whales do, killer whales, orcas. So the belief is... is that we hang around after our ovaries have stopped producing estrogen because it's beneficial to evolution, to society. And this is called the grandmother hypothesis. And there is a lot of research to back it up. So if you compare us to chimps, which are our closest, you know, living relative in the animal kingdom, chimps have very similar menstrual cycles as us. They go through very similar stages, except they die when they run out of eggs, basically, and we keep on living. So that really reframes this whole idea of ovarian failure. This is... I like to think of it as female persistence as opposed to ovarian failure. And it's the idea that living beyond your ability to reproduce is helpful to the collective. And it's helpful because pregnancy is a massive biological toll on humans, much more so than any other animal. And child care for humans is also different because our infants are uniquely vulnerable. Our neurological systems are not developed enough for us to care for ourselves at birth or for many years. And so a grandmother can help offload a lot of those tasks. A grandmother can forage for food, a grandmother can help with shelter, a grandmother can look after the three-year-old, you know, while you're breastfeeding the newborn. And so that's really the idea is that the ability to live beyond our ovarian function helped drive evolution.

CO: There are studies that show that... that a grandmother living in a house, the children tend to be healthier. And, in fact, you looked at one old study of the longer a grandmother lives, the more grandchildren she has. What do you make of that?

JG: Yeah, for every... you know, and this is data from the 1700s. So, you know, for every decade a grandmother lived, there were two additional grandchildren. So I think it shows that grandmothers had a huge worth. And obviously, I don't want to distil a woman's worth to being a grandmother, but it's important to show us how useful grandmothers were, how active, how they contributed, right? That they were... they were actually physically doing things that were helpful to the family unit. They weren't useless. They weren't in their dotage. They weren't, you know, just being trotted out to pat grandkids on the head. They were active, vibrant members of society.

CO: And this is true, I mean, you look at all different kinds of societies as you as you talk about in the book, that there... that there's this period that is looked at, I guess, scientifically as being a kind of the dead zone of being a female, but is actually very productive and nurturing.

JG: Absolutely. If you look at the data that was collected in the 1980s [the doctor] who... who did the research found that when... that at times of need. So, for example, you know, when a mother was breastfeeding, a grandmother might be foraging 37 hours a week for food. And foraging is very physical work, right? So that really dispels this notion of, you know, sitting by the wayside while your bones are crumbling.

CO: You're listening to “As It Happens”. And I'm speaking with Dr. Jen Gunter about her new book, “The Menopause Manifesto: Own Your Health With Facts And Feminism. And you talk about your mother's experience with menopause, and your own as well. So I just want to ask you about... you wrote, my mother's menopause was volcanic. If that was all I had to go on, I would have been quite frightened. What was frightening about your own mother's experience?

JG: Oh, well, I mean, there was a lot of screaming. [chuckling] A lot of... you know, my mother struggled with, you know, some mental health issues that weren't diagnosed until much later in life. And, you know, during that time, I mean, it was like the wheels came off. And it was, you know, walking on eggshells, and never knowing what to expect. And just it was a very, very, you know, frightening time in my house. You know, you just never knew when something was going to enrage her. And, you know, she was so frustrated and angry and uncomfortable and really struggling. And, you know, at the time, I was very frightened. And looking back, you know, maybe the passage of time and also putting it in perspective with the lack of help that she would have had, you know, has, you know, maybe softened my view a little bit.

CO: You point out that sometimes women look to how their mothers went through the menopause to maybe determine what... how their menopause will be. But you said that's not really the case. It's actually if you look to your sister, [chuckle] you might find a better example. But how did your own experience compare with that of your mothers?

JG: Well, you know, mine was... you know, I had some symptoms, but, you know, it... it really wasn't bad. And I don't want to downplay the severity of the symptoms, but I knew what to expect. And I really believe it's sort of that knowledge is really empowering. So when something's happening to your body and you don't know what's going on, and you... and you go and you seek care, and you're dismissed, that's... that just adds insult to injury and makes you feel that much worse. But for me, when I was like, oh, these hot flashes are getting a little bit too much, I think maybe I need to start some... some estrogen. I didn't have those roadblocks, those hassles, those other... the being dismissed, I was never once dismissed. The other thing that I had was I had decades of talking with women across the menopausal diaspora. So I had talked to women who had no symptoms, and women who had had severe symptoms, and those in between. And so knowing that there's this spectrum, knowing that it's not always all bad and that many women are really happy in menopause, like, for example, I love not having a period. [CO laughs] I love, you know, like we're going to go to Hawaii in July. And I love that I don't have to pack a box of pads and tampons.

CO: But you do say that it's nothing to be afraid of. It's a natural process. We should look at it more like puberty is regarded. But then you do go on for much of the book to explain this, [laughing] a bit of a horror show of changes that can happen to some women. So what should they be prepared for?

JG: Well, I just I just want to just backtrack to that point about... I mean, if I wrote a book about puberty, I would also have a chapter on acne. And a chapter on mood swings. You know, so I think that we... we... we all forget that, you know, a lot of bad things do happen to some people or or things that people maybe prefer wouldn't happen during puberty, right? So I'm trying to explain, I would say the breadth of things that can happen, the medical consequences, but it doesn't mean that they're going to happen to everybody. But I really think that having that information really lets you approach it from a place of confidence and a place of empowerment

CO: To go... to stay with the discussion that comparing with puberty, of course, what happens in puberty is that [simple chuckle] the hormone war zone begins and you have all kinds of sexual urges. But what you describe in “The Menopause Manifesto” is the opposite is happening to a lot of women. So what should they expect in regards to their own sex drive?

JG: Yeah, so for some people, libido can absolutely go down in menopause, but it doesn't for everybody. Some people actually report a higher libido. Many women who are freed of their periods and their cramps are like, this is awesome! And I personally love not having to worry about getting pregnant. That's awesome, because pregnancy at 54 would really not be good for me! [both laughing] My... my kids would also be, like, very upset. But, yeah, so I think that, you know, so libido can drop for some women, absolutely. And it's important to... to look at all the potential causes. It could simply be a change in, you know, in libido. But it could also be representative of a relationship change, because if you've been with the same person by the time you're going through menopause, that's a long-term relationship and that requires effort to cultivate desire. If you've had depression triggered by menopause, that can affect libido. If you're not sleeping well, that can affect libido. If you're hot all the time, you do not want someone touching you. I mean, when I'm having a hot flash... because I think I'm in that sort of super-flasher category because I'm still having them, you know, I don't want anyone touching me. Like, I'm so hot. Get off of me.

CO: And just again, going back to words, you don't like the word hot flash. You think that... that hot flush, you think, is a far more descriptive term?

JG: Yeah, I... well, I prefer hot flush because a flash sounds like it's instantaneous. And, to me, it's not. But I personally love the term that dates back at least to the 1700. It's called hot blooms. Be cause it really does feel like it's a blooming out your head. Like, it really does. And that's a term that women came up with. And so I think it would be really cool to be able to reclaim that language.

CO: OK, but all of this is not encouraging, right? [laughing] for women who may be approaching this age, you describe the hot flushes or hot blooms that you’re feeling. [laughing] You don't want anyone to even touch you, your face turns all red, you talk about incontinence, osteoporosis, changes to the brain, changes to emotions, moods, what happened to your mom, all these things. This is, for a lot of women, a very frightening thing that's on the horizon. So what do you say to them?

JG: Well, I say that knowing about all the things that can happen doesn't mean they're all going to happen to you, right? But if you know that that's a possibility, then you can be prepared. So, for example, many women are terrified when they develop brain fog. But this is a temporary thing, and it's not going to last forever. So knowing that it's temporary and not a sign of dementia, hopefully, will be reassuring to a lot of people. Look, I mean, the risk of incontinence absolutely increases with age, but there's so many good treatments. So knowing about it means that you can be proactive. The truth of the matter is, is, you know, as we age, things don't always work as well as they did. But we have medicine to help in so many ways. So why not be proactive about it if you can?

CO: But you also talk about how a lot of the things that are obviously happening to a woman's body during menopause is happening because of your… it happens to men, too, your ageing. So how do you know the difference? I mean, can you tell the difference between those things which are just temporary because it's part of the change and what might actually be something that is… [laughing] I guess heading toward decrepitude of some kind or another?

JG: Well, the thing is you can't really separate menopause from ageing specifically, right? Because every woman born with ovaries who's 55 is also in menopause, right? So you can't have a study of, you know, 55-year-old-plus women who are ageing and have a control group that have menopause, right? But I think it's important to understand that, you know, these things... these things can be additive. So, for example, you know, we... there's an increased risk of heart disease with age. We know that. There's also an added increased risk of heart disease, you know, with menopause. So it can be really hard to tease out because as we age, we accumulate medical conditions. As we age, we age. And as we age, we go through menopause. And I think this is part of the reason why, you know, it's simply not possible in a 15 or 20-minute office visit to tease things out. It's really quite complex for people. And, you know, I think that part of the way we have to approach this is we have to really look at how... how medicine is able to deliver care to people because you simply cannot sort it out in 15 or 20 minutes.

CO: This is “As It Happens”. And I'm speaking about the new book, “The Menopause Manifesto”, with its author, Dr. Jen Gunter. And just talking for a moment about those things that can help. You also are quite concerned with efforts to help menopausal women that are not helpful. Can you talk about some of the worst offenders in your view?

JG: Sure. So there's a lot of predatory products because whenever there's gaps in medicine, predators move in. And there are gaps here. So we see a lot of very scammy supplements that are sold making bold claims. The latest one, I've seen a specialized vitamins that you can go in and put in your health concerns and then it will 3D print you a gummy with... with the right vitamins for you and supplements for you and your menopause. And so I... you know, I entered my stuff, and it gave me basically a toxic dose of vitamin A.

CO: [chuckling] Oh dear!

JG: So like none of these products are tested. Many of them, you don't even know what's in them. Another huge issue is the compounded hormone market, which is really frightening. So these compounded products are, you know, made up by compounding pharmacies. And, you know, doctors and naturopaths order it and they often do it based on blood tests or salivary tests or urine tests, which are all unreliable and should not be used to guide hormone therapy. And the problem is compounded therapies is they're untested. They... you don't know what you're absorbing. So when I use my estradiol patch, I know exactly how much is getting into my bloodstream. I know if this dose can protect me from osteoporosis, how... what percentage of hot flashes or flushes will be reduced by this dose. So I know exactly what it can do for my body. If you use a compounded estrogen product made by a compounding pharmacy, you have none of that data because it hasn't been tested. You could be absorbing too much of the estrogen, you could be absorbing too little. And many of these compounded products also have hormones that we do not recommend. We also have a burgeoning market with these so-called testosterone pellets, which are absolutely contraindicated and can produce sky-high levels of testosterone. And can have really serious repercussions. So there's a huge market here with so-called customized, compounded hormones, and I strictly advise against them.

CO: Well, as the population ages, more and more women going into menopause, I guess this kind of snake oil is going to increase, right? These efforts to sell these kinds of stuff to women. So what can... how can women protect them against this kind of stuff?

JG: Well, I think that it's really important, especially for something that's a supplement or something that's not a pharmaceutical, is that when you take a pharmaceutical, and obviously there's issues with the pharmaceutical industry, but a pharmaceutical has passed some levels of standardization. There is a level of accountability. You know, what you're taking is what you're taking. And people think that when you buy something over-the-counter or you get something from a compounding pharmacy, that it's subject to the same level of regulation and oversight. And it's simply not. I think that getting educated is a good way, telling your physicians what you're taking and checking your information against reliable sources. So in Canada, that would be the Society of Obstetricians and Gynaecologists of Canada. They have great information on their website. In the U.S., that might be the North American Medical Society. And, you know, the North American Menopause Society would be an equally valid source for people in Canada to check as well.

CO: Isn't it possible, though, that there are alternative therapies that might be helpful but haven't been studied, perhaps because they're designed to help women and they just don't get the attention they need?

JG: Well, I would push back against that and say that if you have a product that you believe can help people, it is your duty to test it and to prove it. Nobody should take your word for it. I mean, otherwise, you know, I can make up something from my backyard and tell you it's going to be helpful. You know, when people are selling a product, they get profit from that, right? And we have seen this long history of women being victimised by understudied things in medicine -- the Dalkon Shield, for example, thalidomide, supplements could be like that. We don't know. I mean, for example, there is an increased risk of liver failure with black cohosh supplements. Supplements are the leading cause of medication-induced liver failure. So there should not be this assumption because something isn't studied that it's safe. You know, we don't know. And the... the due diligence for women is... is for these companies to prove their products do what they say.

CO: I suspect you actually could come up with something from your backyard and that would be helpful. [laughs] I would trust you on that one.

JG: [laughing] Well, but I wouldn't do that. That's the whole thing. Hopefully that's why people trust me.

CO: [laughing] This too... this book, “The Menopause Manifesto”, obviously a companion to your previous bestseller, “The Vagina Bible”. This... this book, though, who is this book for? Who is your... who do you see reading this and needing this book?

JG: Well, I think the... the group that is probably going to be helped the most are women in the menopause transition. So starting that time of hormonal chaos. However, I actually believe every person should read it because the way we are treated in menopause is a reflection of society and we need to change that narrative. Why shouldn't when you're 12 or 13 or 14 or 15 understand your whole ovarian functioning, why should you just to have your education about your body be sort of limited to the narrow scope of pregnancy prevention, right? Because that's also puberty culture. I think a lot of people forget that. We only talk to teens about pregnancy prevention. That's really an extension of puberty culture. People should know how their body works. So I think everybody should know this, especially because choices that you make in your 20s and 30s may affect your menopause. And, you know, if you... if you're a smoker, maybe the information in this book will... will prompt you to quit. Maybe it will prompt you to take up an exercise program because exercise and being physically active is probably the most protective thing you can do for your menopause and your health in general.

CO: What do you hope that this book changes then for women?

JG: I hope it, first of all, makes them feel less alone. You know, when I was on tour for “The Vagina Bible”, I heard so many women tell me they felt lonely in menopause, that they had no culture. And so I hope it changes that. I hope it helps them see where menopause fits in history. I hope it makes them see that menopause is a sign of strength. The fact that we evolved to live beyond our ovarian function and other animals didn't says something about our strength. And I hope it helps them understand the changes that are happening to their bodies so they can be empowered. So if something is bothersome, they can get help. And they have the information to do the right preventative care so they can continue to be as a vital and important member of society throughout their whole lifespan.

CO: Jen Gunter, it's good to talk to you. And thank you for this book.

JG: Thank you so much.

CO: Take care.

JG: Thanks.

CH: Jen Gunter is a gynecologist and pain medicine physician. Her new book The Menopause Manifesto is published by Random House Canada. We reached her in Sunnyvale, California. And we've got more on this interview on our webpage at: www.cbc.ca/aih.

May 27, 2021 Episode Transcript

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